Oncology

Question 1

Neutropenic enterocolitis

Answer 1

Major Criteria:
- Neutropaenia, < 500 x 109 cell/L
- Bowel wall thickening on CT exam or US exam
- Fever, > 38.3c oral or rectal
- > 4 mm (transverse scan) thickening in any segment of the bowel for at least 30 mm length (longitudinal scan)

Minor Criteria
- nonspecific Abdominal pain > on pain scale
- Abdominal distention
- Abdominal cramping
- Diarrhoea
- Lower GI bleeding

Question 2

R-CHOP chemo Regimen

Answer 2

• Rituximab,
• Cyclophosphamide,
• Doxorubicin,
• Vincristine, and Prednisone

Question 3

Anti-Neoplastic drugs and Skin Extravasation

Answer 3

1. Irritant Anti neoplastics:
   - alkylating agents, platinum drugs, topoisomerase I inhibitors and 5-FU
2. Vessicant Anti-Noeoplastics: tissue damage, edema, blistering, gangrene
   - Vinca alkaloids, anthracyclines, and taxanes
3. Non-vesicants are responsible for temporary erythema and oedema upon extravasation. Examples include cytarabine, gemcitabine and asparaginase.

Question 4

Managing Chemo Extravasation

Answer 4

General treatment measures include discontinuation of the infusion, aspiration of fluid from the IV line, and elevation of the limb. Cold compressions are used for almost all drug extravasations; however, the management of vinca alkaloid extravasation is unique in requiring warm compressions to dissipate the drug from the affected site. Hyaluronidase helps reduce discomfort and latent cellulitis. Dexrazoxane and sodium thiosulfate are used for the extravasation of anthracyclines and cisplatin respectively.